Patient Care Week 5 Flashcards
Define surgical asepsis (sterilization)
Complete removal of all mo’s and their spores from the surfaces of any object using heat or chemicals
Prevents mo’s from entering body
Use when skin is penetrated
Where would an RT use surgical asepsis?
- surgery
- cardiovascular interventional procedures
- injections: (arthrograms, myelograms, etc.)
- catheterizations: urinary, coronary, etc.
- dressing changes
What are common causes of contamination?
- contaminated instruments or gloves
- allowing sterile field to become wet
- MO’s blowing into surgical site
Operating room
Designed to prevent MO’s from blowing into surgical suite
- ventilation ducts have filters
- OR has positive pressure
Autoclaving
Steam under pressure
• for items that can withstand high temperatures and moisture
• most commonly used method
• color indicators designate sterilization
Temp: 121 degrees C (250 degrees F)
Methods of sterilization
- autoclaving
- gas
- chemical sterilization
- dry heat
- ionizing radiation
Gas for sterilization
Mixture of ethylene oxide and co2
Heated to 57.3 degrees C ( 135 degrees F)
Humidity of 50%
- for items that cannot withstand heat
- takes too long- not preferred method
- gas penetrates porous materials
- objects must be allowed to air out
Chemical sterilization
Unsatisfactory- no way to insure sterilization
- uses activated gluteraldehyde
- immersion time is from 10-24 hours
Dry heat sterilization
Slow and uneven
Rarely used in hospitals
- for anhydrous oils, petroleum products and powders
- or for delicate surgical instruments
Ionizing radiation
Cobalt 60 is used
• used only in commercial sterilization and not in hospitals
Disinfection
Means that as many mo”s as possible are eliminated from surfaces by chemical or physical(friction) means
- note: different than sterilization
- spores are not killed
- uses agents known as disinfectants and antiseptics
Disinfectant agents
Strong chemicals used to clean inanimate objects
- tables, floors, walls, and equipment
- not for use on skin- chemicals too harsh
Antiseptic agents
A type of antibacterial agent safe for skin use on skin
- prevents mo’s from entering body through broken skin
- use when skin is to be penetrated
Chemicals in hospital use
In order to be acceptable, must protect against the following
- staphylococcus Aureus
- Salmonella Choleraesulis
- pseudomonas aeruginosa
Storage of sterile materials
Expiration dates are stamped on all materials
Storage areas must be clean, dust free and draft free
Stored in a closed cupboard or on a open shelf
What is the shelf life for items stored in a closed cupboard?
30 days
What is the shelf life for items stored on an open shelf?
21 days
What is the shelf life for items sealed in plastic bags immediately after sterilization?
6 to 12 months
The items are no longer considered sterile…
- if the seal is broken
- if package is damaged
- if expiration date has been exceeded
- if there is no expiration date
- if in doubt, throw it out
Rules for surgical Asepsis
A. know which areas and objects are sterile and which are not. Keep them separate
B. When contamination occurs, remedy immediately
C. Injections are considered sterile procedures(myelograms, arthrograms, arteriograms, etc)
D. If a table is to be used to support a sterile field, the table must be disinfected first, then a sterile drape is placed over it
E. if personnel are to be considered sterile, they must wear sterile gowns and sterile gloves
F. If an area on a sterile field has become contaminated, the area should be covered by a folded sterile towel or a drape of double thickness
G. If a sterile persons gown or gloves become contaminated, they must immediately change into clean ones
H. Never leave a sterile field unattended
I. If there is doubt about the sterility of an object, consider it contaminated
J. Never reach across a sterile field
K. Anything below the level of the tabletop or below waist level is considered unsterile
L. The only part of the gown considered sterile is the front, from the waist up, including the sleeves
M. Two sterile people must pass each other back to back, or front to front
N. sterile staff must stay in the sterile area
O. The edges of the sterile wrappers are not considered sterile, so they must not touch sterile objects
P. The sterile person faces the sterile field and keep gloved hands above the waist and in fron of the chest
Q. The sterile person touches only sterile objects
R. The sterile person does not lean on tables, walls, etc
S. an object that has become wet is considered contaminated
T. An object wet with bacteriiocides must first be placed on sterile towels to absorb excess moisture
U. Wet areas on the sterile field must be covered with several thicknesses of dry sterile toweling or drapes
V. All areas used for sterile procedure including floors, should be disinfected after each use
W. re-usable flasks containing sterile solution
• date it when opened (and time of day)
• open the lid face upward, and do not touch the inside of lid
• pour a small amount of solution as a discard before using
• after 24 hours, the sterile solution is no longer considered sterile
X. Before surgical scrub
• open first: gown, gloves, scrub sponges
• do you have sterile covers for cassettes and tube before starting?
• disinfect the table, x-ray equipment, etc
• film badge on? Scrubs? Cap? Mask?
• collect lead aprons if imaging during procedure (wear under sterile clothing)
When does an RT get involved in skin prep?
- procedures requiring skin puncture or incision
- applying or changing of sterile dressings
Examples:
- LP, for myelograms
- arterial catheterization
- any procedure where a needle, catheter or wire is inserted through the skin
